july 2021

Smile Foundation



Telemedicine: Key to Achieving Universal Health Coverage in India?

The COVID-19 pandemic has brought to the fore the dire need for the implementation of Universal Health Coverage (UHC). UHC goals have never been more critical than now.

India has a clear divide in the realm of healthcare with the urban population being in a position to seek medical attention both during the lockdowns and otherwise. In contrast, rural and peri-urban populations have faced grave limitations with respect to accessing healthcare because of the shortage of services and access to them, especially for women.

However, with the use of telemedicine, geography will become immaterial and demand can be shared uniformly across a panel of doctors.

The concept of telemedicine works on the simple principle of providing healthcare services from a distance, and this answers the need of providing healthcare in India, even in the hinterlands. While public healthcare centres (PHCs) are essential for providing physical connectivity until the last mile, their integration with telemedicine centres can aid in an evolved and superior system of healthcare delivery.

It is crucial that telemedicine aids in reaching out to areas not reached rather than replacing existing infrastructure. Additionally, mobile healthcare units can also be deployed to work in tandem with telemedicine to reach people where internet connectivity is low or unreliable

Telemedicine can address the gaps in primary healthcare to a great extent. NITI Aayog’s recent announcement to recognise tele-medicine as a viable mode of remote health consultation points to the same. If implemented well, tele-medicine can revolutionise India’s access to healthcare. In its current state, most of the medical specialists and advanced hospitals are concentrated in urban areas. This leaves approximately 926 million Indians living in villages, small cities, and towns who struggle for adequate care.

The WHO recommended doctor to patient ratio is 1:1000; in India it is 1:1445. And the doctors who are working in remote areas are not equipped to offer any specialised consultation to the patients due to lack of adequate investment in rural healthcare infrastructure.

Through community-based tele-health kiosks in small towns and villages, patients can connect with specialist doctors at the nearest urban hospital. The good news is India continues to have one of the fastest growing bases of internet users where the rural internet users are said to be increasing by 58 per cent annually. By 2034, 80 per cent of India will have digital connectivity. Similar projections are made for access to smartphones. These developments augur well for enhancing healthcare accessibility through digitisation.

Telemedicine can save cost and effort, especially for rural patients, as they will not need to travel long distances for medical consultation and treatment. It can also improve efficiency in terms of coverage of patients per day. The number of examinations can double as compared to OPD consultations, thanks to the streamlining of processes through technology. This can also improve the doctor–patient ratio.

If these challenges are tackled efficiently, India can become the finest success story of the UHC goal provided we come up with solutions that align to the country’s ground realities.

Not just that, telemedicine can also become a thriving investment and entrepreneurship opportunity. Language, digital infrastructure, and awareness will be the game changers for this.

Smile Foundation’s own wheel and spoke structure for healthcare and to provide telemedicine to those in rural areas who do not have access to PHCs is a step in the right direction. The pandemic has simply reiterated the need for this facility at a much larger level

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